Validation of the Asian Midface Volume Deficit Severity Scale

Jingyu Li; Lei Pan; Qing Yun; Jinyu Xia; Linna Wang; Xiaodong Shen; Shaoli Chi; Hongxia Zou; Yanyan Zhao; Sufan Wu

doi:10.1007/s00266-025-04723-0

Validation of the Asian Midface Volume Deficit Severity Scale

Aesthetic Plast Surg. 2025 Jun 25. doi: 10.1007/s00266-025-04723-0. Online ahead of print.

Authors

Jingyu Li¹, Lei Pan¹, Qing Yun², Jinyu Xia³, Linna Wang⁴, Xiaodong Shen⁵, Shaoli Chi⁴, Hongxia Zou⁵, Yanyan Zhao⁶, Sufan Wu⁷

Affiliations

¹ Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, 158# Shangtang Road, Hangzhou, Zhejiang, China.
² Air Force Medical Center, PLA, Beijing, China.
³ Peking University First Hospital, Beijing, China.
⁴ Lanzhou Biotechnique Development Co, Ltd, Gansu, China.
⁵ China National Biotec Group Company Limited, Beijing, China.
⁶ Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, The Chinese Academy of Medical Sciences, Beijing, China.
⁷ Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, 158# Shangtang Road, Hangzhou, Zhejiang, China. sufanwu@163.com.

PMID: 40563008
DOI: 10.1007/s00266-025-04723-0

Abstract

Background: Anatomical differences in facial aging and aesthetic needs of Asian and Caucasian individuals have led to disparate clinical rejuvenation strategies using filler augmentation for midface volume deficits. Therefore, the Asian Midface Volume Deficit Severity Scale (AMVDSS) by LBTD (Lanzhou Biotechnique Development Co, Ltd) was developed to objectively assess midface volume deficits and clinical outcomes of Asian individuals.

Methods: Four observers independently rated randomized photographs (front, left and right 45°, left and right 90°) of 65 patients during two sessions with a 2-week interval using the AMVDSS.

Results: All participants were Asian (18 male and 47 female participants; mean age, 40.9 years; range, 20-76 years). Interobserver agreement was substantial to almost perfect for the left (weighted κ, 0.778-0.907) and right (weighted κ, 0.774-0.938) during the first session; it was almost perfect for the left (weighted κ, 0.844-0.907) and right (weighted κ, 0.805-0.876) during the second session. Interobserver agreement was 76.9% to 90.8% and 76.9% to 93.9% for the left and right, respectively, during the first session; it was 84.6% to 90.8% and 81.5% to 87.7% for the left and right, respectively, during the second session. Intraobserver agreement was "almost perfect" for both the left (weighted κ, 0.950; 95% confidence interval [CI] 0.923-0.977) and right (weighted κ, 0.954; 95% CI 0.928-0.980). Exact intraobserver agreement was 95.0% (range, 90.8-100.0%) for the left; it was 95.4% (range, 94.9-96.9%) for the right.

Conclusions: The AMVDSS by LBTD could be used to reliably assess midface volume deficits or volume changes after dermal filler injections.

Level of evidence ii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords: Aesthetics; Asian; Dermal fillers; Midface volume; Validation studies.